More Than Money: Making a Difference With Assistance Beyond the Grant

Examines foundation efforts beyond grantmaking such as training, advocacy, and new investment strategies to increase grantee effectiveness and impact. Assesses the benefits of such help, grantees' views, and implications. Includes case studies

Cardiovascular consequences of cortisol excess

Cushing's syndrome is a consequence of primary or, more commonly, secondary oversecretion of cortisol. Cardiovascular disease is the major cause of morbidity and mortality in Cushing's syndrome, and excess risk remains even in effectively treated patients. The cardiovascular consequences of cortisol excess are protean and include, inter alia, elevation of blood pressure, truncal obesity, hyperinsulinemia, hyperglycemia, insulin resistance, and dyslipidemia. This review analyses the relationship of cortisol excess, both locally and at tissue level, to these cardiovascular risk factors, and to putative mechanisms for hypertension. Previous studies have examined correlations between cortisol, blood pressure, and other parameters in the general population and in Cushing's syndrome. This review also details changes induced by short-term cortisol administration in normotensive healthy men

Portfolio pointers: Preparing and presenting high quality teaching portfolios

This goal of this project was to develop a set of guidelines for creating teaching portfolios for the Tertiary Teaching Excellence Awards or for other purposes. It includes key pointers to “getting started”, collecting evidence, interrogating practice, editing, and protecting the unique “voice” of the nominee and their student body. The guidelines consist of general principles and practical examples from both successful academic developers and award recipients and some examples from award-winning portfolios to illustrate good practice

HIV Services for Mental Health Consumers with Hearing Impairment: Risk Assessment and Prevention Strategies

This paper describes an HIV risk assessment screening for deaf clients with severe mental ilnes at a large psychosocial rehabilitation agency in Chicago, IL. The agency has developed education, prevention, and ongoing support services to respond to the needs of this at-risk population. The results of an HIV risk assessment screening of 39 clients with this dual diagnosis are presented, detailing the numbers and characteristics of clients who report engaging in high risk sexual and drug use behaviors. Reported rates of sexual activity, number of partners, sexually transmitted disease history, intravenous and recreational drug use behaviors, and alcohol use are reported along with knowledge levels about HIV and modes of transmission. Also discussed are issues and concerns relevant to people with mental illness who are deaf, including a summary of an agency HIV education group conducted in sign language

Deletion of Tsc2 in nociceptors reduces target innervation, ion channel expression, and sensitivity to heat

AbstractThe mechanistic target of rapamycin complex 1 (mTORC1) is known to regulate cellular growth pathways, and its genetic activation is sufficient to enhance regenerative axon growth following injury to the central or peripheral nervous systems. However, excess mTORC1 activation may promote innervation defects, and mTORC1 activity mediates injury-induced hypersensitivity, reducing enthusiasm for the pathway as a therapeutic target. While mTORC1 activity is required for full expression of some pain modalities, the effects of pathway activation on nociceptor phenotypes and sensory behaviors are currently unknown. To address this, we genetically activated mTORC1 in mouse peripheral sensory neurons by conditional deletion of its negative regulator Tuberous Sclerosis Complex 2 (Tsc2). Consistent with the well-known role of mTORC1 in regulating cell size, soma size and axon diameter of C-nociceptors were increased in Tsc2-deleted mice. Glabrous skin and spinal cord innervation by C-fiber neurons were also disrupted. Transcriptional profiling of nociceptors enriched by fluorescence-associated cell sorting (FACS) revealed downregulation of multiple classes of ion channels as well as reduced expression of markers for peptidergic nociceptors in Tsc2-deleted mice. In addition to these changes in innervation and gene expression, Tsc2-deleted mice exhibited reduced noxious heat sensitivity and decreased injury-induced cold hypersensitivity, but normal baseline sensitivity to cold and mechanical stimuli. Together, these data show that excess mTORC1 activity in sensory neurons produces changes in gene expression, neuron morphology and sensory behavior.</jats:p

Assessing the Need for a Social Worker at the Chittenden Emergency Food Shelf

Introduction: Chittenden Emergency Food Shelf (CEFS) Largest direct service emergency food provider in Vermont Serves over 12,000 people/year Works to alleviate hunger through grocery services, hot meals, and home delivery Offers a culinary job training program CEFS seeks to understand client need for assistance in accessing/coordinating additional public assistance services and resources. Could CEFS improve its services by staffing a social worker on site? Project Goal: Collect data from CEFS users to assess current need for in-house social worker to assist with diverse needs beyond emergency food assistance.https://scholarworks.uvm.edu/comphp_gallery/1225/thumbnail.jp

Hospitals caring for rural Aboriginal patients: holding response and denial

Open Access article published under a CC-BY-NC-ND licence: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/deed.en_US).Objective To investigate how policy requiring cultural respect and attention to health equity is implemented in the care of rural and remote Aboriginal people in city hospitals. Methods Interviews with 26 staff in public hospitals in Adelaide, South Australia, were analysed (using a framework based on cultural competence) to identify their perceptions of the enabling strategies and systemic barriers against the implementation of official policy in the care of rural Aboriginal patients. Results The major underlying barriers were lack of knowledge and skills among staff generally, and the persistent use of ‘business as usual’ approaches in their hospitals, despite the clear need for proactive responses to the complex care journeys these patients undertake. Staff reported a sense that while they are required to provide responsive care, care systems often fail to authorise or guide necessary action to enable equitable care. Conclusions Staff caring for rural Aboriginal patients are required to respond to complex particular needs in the absence of effective authorisation. We suggest that systemic misinterpretation of the principle of equal treatment is an important barrier against the development of culturally competent organisations. What is known about this topic? The care received by Aboriginal patients is less effective than it is for the population generally, and access to care is poorer. Those in rural and remote settings experience both severe access barriers and predictable complexity in their patient care journeys. This situation persists despite high-level policies that require tailored responses to the particular needs of Aboriginal people. What does this paper add? Staff who care for these patients develop skills and modify care delivery to respond to their particular needs, but they do so in the absence of systematic policies, procedures and programs that would ‘build in’ or authorise the required responsiveness. What are the implications for practitioners? Systematic attention, at hospital and clinical unit level, to operationalising high policy goals is needed. The framework of cultural competence offers relevant guidance for efforts (at system, organisation and care delivery levels) to improve care, but requires organisations to address misinterpretation of the principle of equal treatment